Fluid & Electrolytes Overview
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Questions and Answers

What is insensible loss?

  • Diarrhea
  • Breathing
  • Urination
  • Perspiration and sweat (correct)

    • What % of body fluid is ICF and where is ICF found?

    2/3 of body weight-fluid inside of cells

    What is ECF?

    1/3 of body weight-fluid outside of cells

    What are the 3 components of the ECF?

    <p>Interstitial, Intravascular, Transcellular</p> Signup and view all the answers

    What is the interstitial space?

    <p>Fluid between the cells and outside of blood vessels (contains lymph)</p> Signup and view all the answers

    How does adipose tissue and fat relate to a person's water quantity?

    <p>The more adipose tissue and fat you have the less water you will have because the fat is pushing out the water or taking up the space where the water would be.</p> Signup and view all the answers

    What areas in the body have the highest amount of water?

    <p>Muscle, skin and blood</p> Signup and view all the answers

    What is the intravascular compartment?

    <p>Blood plasma within the vein</p> Signup and view all the answers

    What is the transcellular compartment?

    <p>CSF, sweat, peritoneal, synovial and pleural 'protective component'</p> Signup and view all the answers

    What does the blood volume represent?

    <p>What is inside the intravascular space</p> Signup and view all the answers

    What is the electrolyte unit of measurement?

    <p>mEq</p> Signup and view all the answers

    What are 3 ways we intake water?

    <p>Drinking, ingesting food and oxidation of food during metabolic processes (500mL/day)</p> Signup and view all the answers

    What is Cl- 'married' to---following each other?

    <p>sodium</p> Signup and view all the answers

    What two electrolytes use mg/dL?

    <p>Ca++ and PO4-</p> Signup and view all the answers

    In acid-base balance are we talking about arterial or venous side?

    <p>Arterial</p> Signup and view all the answers

    In fluid and electrolyte shifts are we talking about arterial or venous side?

    <p>Venous</p> Signup and view all the answers

    What is the number one indicator for whether or not the patient has adequate fluid balance and they are shifting their fluids properly?

    <p>Urine output</p> Signup and view all the answers

    What is osmosis?

    <p>Movement of fluid from a lesser solute concentration to an area of greater solute concentration to equalize</p> Signup and view all the answers

    What is osmotic pressure?

    <p>The drawing power. If there is a high solute concentration there is a high osmotic pressure that draws water into itself.</p> Signup and view all the answers

    What is osmolarity?

    <p>Tells us the amount of water in comparison to the solutes</p> Signup and view all the answers

    What do hypertonic solutions have in them?

    <p>More molecules, electrolytes and ions in them</p> Signup and view all the answers

    What do hypertonic solutions do to the cell?

    <p>Shrink it</p> Signup and view all the answers

    Why would you want to shrink a cell using hypertonic solutions?

    <p>Have too much ICF and the cell is too big and the intravascular space (blood volume) is dehydrated. So you hydrate intravascular by shrinking the cell.</p> Signup and view all the answers

    What are some hypertonic IV solution examples?

    <p>D10W, NS3-5%, D5W in 0.9%NS, D5W in 0.45%NS, D5W in Lactated Ringers</p> Signup and view all the answers

    What is isotonic solutions used for?

    <p>Maintaining fluid shift, no change occurs in the cell</p> Signup and view all the answers

    What does isotonic solutions do to the fluid compartments?

    <p>Expands the ECF (intravascular) because it is where the IV is going</p> Signup and view all the answers

    What are some isotonic IV solution examples?

    <p>Dextrose 5%, Lactated Ringers, NS 0.9% (sodium chloride)</p> Signup and view all the answers

    Why would you want to fatten a cell using hypotonic IV solutions?

    <p>Solute concentration is too low, cell is dehydrated</p> Signup and view all the answers

    What does the hypotonic IV solutions do?

    <p>Shifts fluids from intravascular into intracellular. Provides more lytes and dilutes ECF</p> Signup and view all the answers

    What is an example of a hypotonic IV solution?

    <p>(1/2 NS) NS 0.45%</p> Signup and view all the answers

    What do you need to be cautious of when giving hypotonic IV solution?

    <p>That the ECF doesn't become dehydrated</p> Signup and view all the answers

    What are colloids used for?

    <p>Shifting fluid from the interstitial back into the intravascular.</p> Signup and view all the answers

    What is meant by the semi-permeable membrane being 'leaky'?

    <p>The fluid and proteins shift from the intravascular space into the interstitial space '3rd spacing'</p> Signup and view all the answers

    Why doesn't a diuretic work on a leaky semi-permeable membrane?

    <p>Because meds work on the intravascular space and the overload of fluids is in the interstitial space.</p> Signup and view all the answers

    What is an example of a colloid?

    <p>Albumin-given IV</p> Signup and view all the answers

    What does it mean when you see a patient who has low albumin and protein levels?

    <p>Patient has leaky membranes and is at risk for fluid shifts into the interstitial space</p> Signup and view all the answers

    What is diffusion?

    <p>Moving solutes over semi-permeable membrane from high concentration to low concentration.</p> Signup and view all the answers

    What is an example of diffusion?

    <p>Oxygen and Carbon dioxide being distributed at the alveolar level.</p> Signup and view all the answers

    What should the GFR be at?

    <p>Greater than 60</p> Signup and view all the answers

    What does creatinine indicate?

    <p>Kidney dysfunction</p> Signup and view all the answers

    What does BUN indicate?

    <p>Dehydration</p> Signup and view all the answers

    What does a high BUN & creatinine indicate?

    <p>Kidney dysfunction</p> Signup and view all the answers

    What is filtration?

    <p>Water and solutes moving from an area of higher pressure to an area of lower pressure.</p> Signup and view all the answers

    What is the active transport?

    <p>Allows larger molecules to enter moving along a concentration gradient from an area of greater concentration to an area of lesser concentration.</p> Signup and view all the answers

    What is the primary electrolyte in the ICF?

    <p>K+</p> Signup and view all the answers

    What are the primary electrolytes in the ECF?

    <p>Na+ and Cl-</p> Signup and view all the answers

    What are patients at risk for when on hypertonic IV's?

    <p>Volume overload</p> Signup and view all the answers

    What is D5W?

    <p>Isotonic</p> Signup and view all the answers

    What is D10W?

    <p>Hypertonic</p> Signup and view all the answers

    What is 1/2 NS (0.45% NS)?

    <p>Hypotonic</p> Signup and view all the answers

    What is NS 0.9%?

    <p>Isotonic</p> Signup and view all the answers

    What is NS 3%-5%?

    <p>Hypertonic</p> Signup and view all the answers

    What is D5W in 0.9%NS?

    <p>Hypertonic</p> Signup and view all the answers

    What is D5W in 0.45%NS?

    <p>Hypertonic</p> Signup and view all the answers

    What is lactated ringers?

    <p>Isotonic</p> Signup and view all the answers

    What is D5W in lactated ringers?

    <p>Hypertonic</p> Signup and view all the answers

    What is the normal level of BUN?

    <p>10-20</p> Signup and view all the answers

    What is the normal level for creatinine?

    <p>0.5-1.5</p> Signup and view all the answers

    Study Notes

    Fluid & Electrolytes Overview

    • Insensible Loss: Refers to fluid loss through perspiration and sweat, not easily measured.

    Body Fluid Composition

    • ICF (Intracellular Fluid): Comprises 2/3 of body fluid, found within cells; major site of potassium (K+).
    • ECF (Extracellular Fluid): Accounts for 1/3 of body fluid, located outside of cells; includes interstitial, intravascular, and transcellular compartments.

    ECF Components

    • Interstitial Fluid: Fluid between cells and outside blood vessels, contains lymph.
    • Intravascular Compartment: Blood plasma within the veins, essential for circulatory function.
    • Transcellular Compartment: Encloses fluids like cerebrospinal fluid (CSF), sweat, and synovial fluid.

    Factors Influencing Body Water

    • Adipose Tissue Impact: Higher fat content leads to lower water volume as fat takes up space.
    • Water-Rich Areas: Muscle, skin, and blood are primary areas containing substantial amounts of water.

    Fluid Balance Indicators

    • Urine Output: The primary indicator for assessing fluid balance and proper fluid shifting.
    • Osmosis: Fluid movement from lesser to greater solute concentration, aiming for equilibrium.
    • Osmotic Pressure: The force that draws water towards high solute concentration; relevant in conditions like increased intracranial pressure.
    • Osmolarity: Measures the concentration of solutes relative to water in a solution.

    Solution Types and Effects

    • Hypertonic Solutions: Contain more solutes, causing cells to shrink as fluid moves from ICF to ECF for hydration. Examples include D10W and D5W in 0.9% NS.
    • Isotonic Solutions: Maintain fluid shift without changing cell size; expand ECF. Examples are Lactated Ringer's and NS 0.9%.
    • Hypotonic Solutions: Shift fluid into cells when ECF solute concentration is too low. An example is 0.45% NS.

    Other Key Concepts

    • Colloids: Used to shift fluid back to intravascular space, effective in treating third-spacing.
    • Leaky Membranes: Indicates pathology where proteins and fluid escape to interstitial space, leading to complications with diuretics.

    Diffusion and Filtration

    • Diffusion: Movement of solutes from high to low concentration across a semi-permeable membrane, such as oxygen and carbon dioxide exchange in the lungs.
    • Filtration: Process of moving water and solutes from higher to lower pressure regions.

    Electrolyte Management

    • Primary Electrolytes: K+ is predominant in ICF; Na+ and Cl- dominate ECF.
    • Measurement: Electrolyte levels are measured in mEq, while calcium (Ca++) and phosphate (PO4-) are in mg/dL.

    Renal Function and Fluid Balance Indicators

    • GFR (Glomerular Filtration Rate): Normal value should be greater than 60, indicates kidney filtering capacity.
    • Creatinine & BUN Levels: High levels indicate kidney dysfunction (creatinine) or dehydration (BUN), with normal ranges being 0.5-1.5 for creatinine and 10-20 for BUN.

    Caution with IV Solutions

    • Risk of Overload: Hypertonic IV solutions can lead to volume overload if not monitored carefully, necessitating vigilance in patient management.

    IV Solution Classifications

    • D5W: Isotonic
    • D10W, NS 3%-5%: Hypertonic
    • 0.45% NS (1/2 NS): Hypotonic
    • Lactated Ringer's: Isotonic

    Understanding fluid and electrolyte dynamics is crucial for effective patient care and managing various conditions related to hydration and electrolyte imbalances.

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    Test your knowledge on fluid and electrolyte concepts with these flashcards. This quiz covers definitions and components related to intracellular and extracellular fluids, their locations, and the body's fluid balance. Perfect for nursing or health science students.

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